GREENBAX  Charities 
Charity Application: This application allows your charitable organization to be eligible for Greenbax donations from our Greenbax customers. All organizations must be exempt under Section 501(c)3 of the Internal Revenue Code. Once approved, your Greenbax card will be mailed to the Contact Name specified below.

Full Name of Organization

Employer Identification Number

Street Address Contact Name

City State Zip

Phone Number Fax Number
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Date Incorporated (mm/dd/yy) Web Address Email Address

Description of Organization and Services Provided